ABSTRAK PENGARUH PEMBERIAN KAFEIN ORAL TERHADAP INTERVAL EKG
Vika Fransiska, 2008. Pembimbing : Jo Suherman, dr., MS., AIF Endang Evacuasiany, dra., Apt., MS., AFK Latar Belakang : Kafein banyak terkandung dalam kopi, teh, minuman cola, minuman berenergi, coklat, dan digunakan untuk terapi. Melalui mekanisme kerjanya terhadap SSP kafein meningkatkan kesadaran, mengurangi kelelahan, menurunkan denyut jantung melalui perangsangan vagal dan meningkatkan tekanan darah melalui perangsangan vasomotor medulla. Sedangkan terhadap sistem kardiovaskuler, kafein bersifat inotropik dan kronotropik positif, menurunkan tekanan darah karena merelaksasi otot polos perifer. Kafein memiliki metabolisme kompleks pada sistem sirkulasi dan efek akhirnya bergantung pada kondisi saat pemberian, dosis yang digunakan, dan riwayat pajanan terhadap derivat metilxantin. Tujuan : Penelitian ini bertujuan untuk mengetahui pengaruh kafein terhadap interval EKG Metode : Penelitian dilakukan terhadap 26 mahasiswa FK-UKM yang berumur 20-22 tahun. Pencatatan EKG dilakukan sebelum dan 60 menit sesudah pemberian kafein 150 mg per oral. Analisis data : Memakai uji “t” tes berpasangan dengan α=0,05. Hasil : Hasil percobaan sebelum dan sesudah pemberian kafein menunjukkan adanya perpanjangan RR interval (0.842 s dan 0.976 s ; p < 0.05), PR interval (0.142 s dan 0.157 s ; p < 0.05), QRS interval (0.072 dan 0.080 ; p < 0.05), dan QTc interval (0.360 dan 0.383 ; p < 0.05) Kesimpulan : Pemberian kafein 150 mg dalam posisi berbaring setelah 60 menit ditemukan perpanjangan interval EKG Kata Kunci : Kafein, interval EKG
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ABSTRACT THE EFFECT OF CAFFEIN CONSUMPTION ON ECG INTERVALS
Vika Fransiska, 2008. Tutor : Jo Suherman, dr., MS., AIF Endang Evacuasiany, dra., Apt., MS., AFK Backgrounds : A great amount of caffeine is found in coffe, tea, cola drinks, energy drinks, chocolate and even used for therapy. Caffeine to Central Nervous System increase wakefullness, decrease fatigue, decrease the heart rate by stimulation on vagal receptor and increase blood pressure through stimulation on vasomotor centre in the medulla. On the other side to cardiovascular system, caffeine is a chronotropic and inotropic positive, decrease blood pressure for its relaxants of smooth muscle perifer. Caffeine has complex actions on the circulatory system and the final effects largely depend upon the conditions prevailing at the time of administration, the dose used, and possibly the history of exposure to methylxanthines. Objectives : To evaluate the effects of single dose caffeine consumption on ECG intervals Methods : This research involved 26 male medical students of Maranatha Christian University, age between 20 to 22 years. A baseline 12 lead ECG was performed and a subsequent 12 lead ECG was performed 60minutes after ingesting caffeine 150mg. Statistical analysis : used paired student “t” test Results : Comparison before and after ingesting caffeine showed a lengthened of RR interval (0.842 s and 0.976 s ; p < 0.05), PR interval (0.142 s and 0.157 s ; p < 0.05), QRS interval (0.072 and 0.080 ; p < 0.05), and QTc interval (0.360s dan 0.383 s ; p < 0.05) Conclusions : After 60 minutes consumption of 150 mg caffeine on basal condition caused elongation of ECG intervals Key words : caffeine, ECG intervals
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DAFTAR ISI
JUDUL LEMBAR PERSETUJUAN ................................................................................ ii SURAT PERNYATAAN .................................................................................... iii ABSTRAK .......................................................................................................... iv ABSTRACT ........................................................................................................... v KATA PENGANTAR ........................................................................................ vi DAFTAR ISI ...................................................................................................... vii DAFTAR TABEL ............................................................................................... x DAFTAR GAMBAR........................................................................................... xi DAFTAR DIAGRAM ....................................................................................... xii DAFTAR LAMPIRAN .................................................................................... xiii BAB I PENDAHULUAN 1.1 Latar Belakang .................................................................................................. 1 1.2 Identifikasi Masalah ......................................................................................... 2 1.3 Maksud dan Tujuan .......................................................................................... 2 1.4 Manfaat Penelitian ........................................................................................... 2 1.5 Kerangka Pemikiran dan Hipotesis Penelitian ................................................. 2 1.6 Metode Penelitian ............................................................................................. 4 1.7 Lokasi dan Waktu ............................................................................................ 5 BAB II TINJAUAN PUSTAKA 2.1 Kafein ............................................................................................................... 6 2.1.1 Sifat Kimia .............................................................................................. 6 2.1.2 Farmakokinetik ....................................................................................... 7 2.1.3 Mekanisme Kerja Kafein pada Taraf Seluler........................................... 8 2.1.4 Efek Farmakologi................................................................................... 10 2.1.4.1Efek SSP ..................................................................................... 10 2.1.4.2 Efek Kardiovaskuler................................................................... 11 2.1.4.3 Relaksasi Otot Polos .................................................................. 14 2.1.4.4 Diuresis ...................................................................................... 14 2.1.4.5 Efek Gastrointestinal.................................................................. 14 2.2 Elektrokardiogram .......................................................................................... 14 2.2.1 Jantung .................................................................................................. 15 2.2.1.1 Struktur Anatomis dan Histologis Jantung ................................ 15 2.2.1.2 Sistem Penghantaran Jantung .................................................... 17 2.2.1.3 Pengaturan Jantung Oleh Saraf Simpatis dan Parasimpatis....... 18 2.2.1.4 Mekanisme Kerja Jantung.......................................................... 18 2.2.2 Pencatatan Elektrogram ......................................................................... 22 2.2.2.1 Sandapan EKG ........................................................................... 24 2.2.3 Definisi Konfigurasi EKG...................................................................... 27 2.2.3.1 Kompleks-kompleks Elektrokardiografik Normal.............................. 27
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BAB III BAHAN DAN METODE PENELITIAN 3.1 Desain Penelitian ............................................................................................ 31 3.2 Objek Penelitian ............................................................................................. 31 3.3 Bahan dan Alat yang Digunakan .................................................................... 32 3.4 Metode Penelitian ........................................................................................... 32 3.4.1 Variabel Penelitian ................................................................................. 32 3.4.2 Prosedur Kerja........................................................................................ 33 3.4.3 Analisis Data .......................................................................................... 33 BAB IV HASIL, PEMBAHASAN DAN PENGUJIAN HIPOTESIS PENELITIAN 4.1 Hasil Penelitian dan Pembahasan ................................................................... 35 4.1.1 Karakteristik Subjek Penelitian ............................................................. 35 4.1.2 Pengaruh Kafein Terhadap RR Interval................................................. 36 4.1.3 Pengaruh Kafein Terhadap PR Interval ................................................. 38 4.1.4 Pengaruh Kafein Terhadap QRS Interval .............................................. 40 4.1.5 Pengaruh Kafein Terhadap QTc Interval ............................................... 42 4.2 Pengujian Hipotesis Penelitian ....................................................................... 44 4.3 Pembahasan .................................................................................................... 44 4.4 Kesimpulan ..................................................................................................... 45 BAB V KESIMPULAN DAN SARAN 5.1 Kesimpulan .................................................................................................... 46 5.2 Saran ............................................................................................................... 45 DAFTAR PUSTAKA ......................................................................................... 47 LAMPIRAN......................................................................................................... 51 RIWAYAT HIDUP PENULIS .......................................................................... 83
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DAFTAR TABEL
Tabel 4.1 Karakteristik OP ................................................................................... 35 Tabel 4.2 Pengaruh Kafein Terhadap RR Interval ............................................... 36 Tabel 4.3 Pengaruh Kafein Terhadap PR Interval ................................................ 38 Tabel 4.4 Pengaruh Kafein Terhadap QRS Interval ............................................. 40 Tabel 4.5 Pengaruh Kafein Terhadap QTc Interval ............................................. 42
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DAFTAR GAMBAR
Gambar 2.1 Struktur Kimia Kafein......................................................................... 5 Gambar 2.2 Sistem Konduksi Jantung ................................................................. 17 Gambar 2.3 Aksi Potensial Otot Jantung ............................................................. 22 Gambar 2.4 Arah Depolarisasi & Repolarisasi Otot Jantung ............................... 23 Gambar 2.5 Sandapan Unipoler Prekordial (Chest Leads) .................................. 25 Gambar 2.6 Sandapan Bipoler Extremitas (Limb Leads)...................................... 26 Gambar 2.7 Aktivitas Jantung dalam EKG........................................................... 27 Gambar 2.8 Konfigurasi EKG .............................................................................. 30
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DAFTAR DIAGRAM
Diagram 2.1 Mekanisme Kerja Kafein Tingkat Seluler ......................................... 8
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DAFTAR LAMPIRAN
Lampiran 1 Lembar Persetujuan Subjek Penelitian ............................................. 51 Lampiran 2 Elektrokardiogram Hasil Percobaan.................................................. 52 Lampiran 3 Data Hasil Percobaan......................................................................... 79 Lampiran 4 Hasil Analisis Data ........................................................................... 81
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